Many things may keep health plan executives awake at night these days. Choosing the best technology solution for ICHRA administration shouldn’t be one of them. While some health plans continue to evaluate how ICHRA aligns with their strategy, others are going all-in. ICHRAs offer a way to accelerate growth, and there is plenty of evidence to support it, according to the 2024 HRA Council Data Report.
For example, Oscar Health and Centene are focusing on the ICHRA space, and they believe it will be a key driver of their strategic plans according to their CEOs’ investor calls. No matter where your organization falls on the spectrum of ICHRA readiness, it’s critical to factor in how the right technology partner can set you up for success and sharpen your competitive edge. Here, we share some considerations.
Properly Supporting ICHRA Members as a Group is Challenging for Everyone
ICHRAs, being a hybrid of a group and individual product, have created several new challenges when it comes to shopping, administration and service. Brokers, employers and health plans need a new experience that combines individual shopping with group administration. Most platforms on the market fail to do that well. Health plans must support individuals they receive as enrollees and allow the group to support and manage their employees.
Without proper data, transparency and group structure, it is difficult ‒ if not impossible when each employee looks the same as other individual members. Brokers now have the challenge of supporting both the employer and individual member shopping. While there is tremendous opportunity ‒ without the right technology and support, it’s challenging to make ICHRA operations work at scale. Let alone, without sharing commissions, delegating agent-of-record and the opportunity to influence the shopping narrative when working with most ICHRA platforms. Manual work for both health plans and brokers persists because most lack robust automation with carriers for enrollment, billing and other functions.
If your ICHRA technology partner(s) offer only partial solutions, offering ICHRA plans may be rife with these challenges. On the other hand, a complete ICHRA quote-to-pay solution built on a group benefits chassis, can help you make the most of this growth opportunity – and differentiate your health plan in the marketplace.
Ask yourself if your ICHRA technology partner enables you to accomplish the following:
- Provide a robust employee shopping experience with the ability for insurance agents/brokers to curate plans and share your health plans’ value.
- Identify and connect an ICHRA group’s employees together so that service and support can be consistent with a familiar group-like experience.
- Automate the entire quote-to-pay process to grow your ICHRA business without ad hoc processes or added manual workloads.
- Retain agent-of-record status and commissions for brokers.
- Position your health plan to protect business and capitalize on increasing market disruption.
If your answer isn’t a resounding “yes,” you may want to think about aligning with a partner who can help you deliver on these key differentiators.
1. Offer a Shopping Experience Designed to Retain and Grow Membership
Most ICHRA shopping platforms leave employees to sift through a large volume of plans in their market. Many shopping experiences can be overwhelming to employees, leaving little opportunity for their education around the value and considerations of different plans or carriers. A shopping experience that allows agents to curate plans on behalf of employers and employees can make the experience more familiar and less overwhelming.
The additional plan choices ICHRAs provide increase employee satisfaction with benefits, however they often will rely on agents for knowledge and support to help them with their plan decisions. A well-designed shopping platform that supports all health plan constituents can help avoid members immediately defaulting to lowest cost plans. While it’s important for a shopping platform to provide agents plan curation tools, it must provide employees access to shop for all other plans available in their market.
2. Maintain Broker Relationships
In addition to wanting to keep their relationships with their group and employees intact, brokers want automated tools that enable them to efficiently quote, enroll and service their clients without manual work and having to manage multiple benefits administration solutions. The right technology partner will deliver on those needs.
ICHRA tends to inherently disintermediate brokers, which can cause brokers to avoid selling these plans. Yet, they have a fiduciary responsibility to offer them to their clients. When they do, however, it may come with unwanted sacrifices in the form of relinquishing commissions and agent-of-record to serve their clients. When they or their firm doesn’t have an agent certified to write individual and family plans, they are forced to seek out and compensate brokerage firms or ICHRA platforms that can. Helping brokers keep their agent-of-record and compensation when writing ICHRA plans isn’t something health plans should sacrifice. Fortunately, Benefitfocus® has a solution that provides this support when an agent needs it, without jeopardizing agent-of-record or commission.
3. Provide the Familiar Group Experience With ICHRA
The group benefits experience has been an industry standard. Unfortunately, health plan systems inherently treat ICHRA members as individuals, which can cause challenges for all constituents. When those members are not tied to a group, they appear as an individual consumer in a health plan’s membership system and may not receive the right notices, engagement materials, and other important information and service. It also creates significant challenges when group administrators need service support. This causes unnecessary administrative work for health plans and employers. Not to mention, it creates more “noise” for brokers.
Benefitfocus® has the only ICHRA solution offering a true group-like experience that ensures members are clearly identified as part of their employer’s group, regardless of plan or carrier selection. Employers can go about their business as usual, receiving the familiar support they expect, while having more control over costs. While ICHRAs are currently growing mainly in the small group market, the ability to deliver a true group-like experience will serve health plans well as the product makes its way up-market.
4. Enabling ICHRA at Scale
ICHRA is already showing signs of making its way up-market. Other platforms have limited automation with carriers to reduce manual burdens. Effective automation enables health plans to scale up and elevate the experience for customers and brokers. Some examples include:
- Automated member enrollment installation with the carrier
- Employee coverage substantiation
- HRA account setup and funding
- Consolidated invoicing
- Electronic premium payment to carrier
- Full quote-to-pay workflow
Without robust automation and TPA services, it will be difficult to scale ICHRA business without adding health plan headcount or adding manual tasks to current staff.
5. Offer ICHRAs in a Differentiated Way
With the right technology partner, your health plan will be in a better position to deliver on expectations and avoid the pitfalls that can limit the ability to grow with ICHRA: Lack of a group experience, disintermediation of brokers, too-little automation and an inability to shape the narrative around a health plans’ value.
The great news is that no matter where your plan is when it comes to offering ICHRAs, there is a solution entry point with Benefitfocus® to quickly meet your needs:
- Launch: Establish ICHRA presence for shopping with HRA contribution strategies* to protect membership.
- Partner: Robust experience, automation and scale with HRA contribution strategies* to compete.
- Operate: Power all commercial offerings with maximum flexibility, and group HRA funding* to drive growth.
The Solution: A Fully Integrated Technology – and Strong Service – Experience
At Benefitfocus®, we solve big-picture problems to better connect the benefits experience – so you can have greater impact in the markets you serve. With technology that makes it simple to scale without adding headcount or additional administration through a suite of TPA services to support sales and HRA administration*, working with Benefitfocus® can help your health plan:
- Manage the entire quote-to-pay lifecycle from a single technology ecosystem that’s maintained and continuously evolving.
- Enhance and maintain your relationships with brokers with a solution that will reinforce their valued-added role.
- Create meaningful connections with your members, brokers, and employer groups year-round through an engaging and hyper-personalized experience.
- Simplify administration, drive efficiencies and enable you to focus on what’s most important.
- Deliver an outstanding user experience for your internal staff, partners and customers.
- Harness powerful data-driven insights to help you identify key cost drivers and improve member health outcomes.
There’s no denying that most health plans need a way to respond quickly and competitively to the ICHRA opportunity. To find out more about how Benefitfocus® can help your health plan, book your free demo today.
*Offered through a third party TPA.
The information provided does not, and is not intended to, constitute legal or tax advice and is not intended to address the situation of any plan, group or individual; instead, all information and content herein is provided for general informational purposes only and may not constitute the most up-to-date legal or other information.
